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Identifying post-traumatic stress disorder after childbirth

BMJ 2022; 377 doi: (Published 10 May 2022) Cite this as: BMJ 2022;377:e067659

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It felt like my birth trauma had been forgotten

  1. Pauline Slade, professor in clinical psychology, consultant clinical psychologist1,
  2. Andrea Murphy, general practitioner and Liverpool Clinical Commissioning Group2,
  3. Emma Hayden, expert by experience
  1. 1Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
  2. 2Woolton House Medical Centre, Liverpool, UK
  1. Correspondence to P Slade pauline.slade{at}

What you need to know

  • One third of women experience giving birth as traumatic, and consequently 3-6% of all women giving birth develop postpartum post-traumatic stress disorder (PTSD), with many going undiagnosed

  • Healthcare providers should ask about birth trauma routinely. Recognising early responses to a traumatic birth and providing advice and support can reduce the risk of PTSD developing

  • PTSD is different from postpartum depression. Although both can occur simultaneously, they require different psychological treatments. Some cases of postpartum depression can be managed in primary care, but postpartum PTSD more commonly requires specialist maternal mental health referral

“My baby was in distress after a long labour, this resulted in a forceps delivery after which I haemorrhaged and sustained injury.

As a new mother I felt frightened all the time, tearful and low, fearing danger around every corner. I was afraid to put my baby down to sleep, or to even walk down the stairs with my new son in my arms. I experienced nightmares and replayed the birth over in my head, wondering what could have happened differently and what I wish I could have changed. I had scary intrusive thoughts that I was concerned to disclose for fear of being judged a bad mother. I felt forever changed mentally and physically by the birth, and wondered if I would ever feel myself again. I loved being a mother and felt guilty that I was struggling. It was a very lonely time as there was no one to talk to who understood or could point me in the right direction for help. My husband knew I was struggling, but was at a loss to know what to do, so we both did our best to attempt to deal with things alone.”

One in three people will find giving birth a traumatic experience, with 3-6% going …

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